The incidence and prevalence of treated end-stage renal disease (ESRD) has increased relentlessly in the U.S. since initiation of the Medicare ESRD Program in 1973. Many more Americans have less severe forms of chronic kidney disease. Thus there is a national need to train more scientists to study this societal health problem. Renal disease epidemiology offers the potential to help reduce the morbidity, mortality and societal costs associated with kidney disease and is a natural complement to the substantial strengths in basic science research in renal disease. This proposal is a competitive renewal application, years 16 to 20, for a NRSA to fund a Renal Disease Epidemiology Training Program at The Johns Hopkins Medical Institutions. The Program is based in the Welch Center for Prevention, Epidemiology, and Clinical Research and the Department of Epidemiology;it takes advantage of the faculty's strengths in the application of epidemiologic methods to important issues in renal disease and their ability to bridge the disciplines of basic science and epidemiology. A program Director (Dr. Klag), co-director (Dr. Appel), and 10 other nationally recognized renal disease epidemiologists serve as faculty advisers;3 other faculty with experience in renal disease epidemiology are also available for mentorship. An Advisory Committee of institutional leaders and internationally recognized researchers advise the directors and monitor progress. We have demonstrated our ability to recruit high quality candidates and rigorously train them in clinical and epidemiologic renal research methods. Over the last 10 years, a total of 18 trainees have been supported, 5 of whom are still in training. Of the remaining 13, 12 are pursuing academic careers. These trainees have published 155 papers. This funding has revitalized the Pediatric Nephrology fellowship at our institution, forged close collaborative relations between the participating units, and produced a cadre of successful young investigators who are doing innovative research at Johns Hopkins and other institutions across the US.. PUBLIC HEALTH RELEVANCE: This program provides rigorous training in statistics, epidemiology, and clinical research methods to future leaders who will find new ways to prevent and treat kidney disease. The faculty and trainees form collaborations and use state-of-the art methods to characterize risk factors, including genes, for kidney disease as well as to design and carry out clinical trials. This program has profoundly influenced the curriculum and research agenda of the Johns Hopkins Medical Institutions.